Confidentiality and ethics quiz

Would you know what to say if you were asked to disclose details of patient care by the police? What if a journalist asks for your side of the story following a complaint? Try this quiz to find out how well you understand your duty to protect patient confidentiality.

A 15-year-old amateur footballer has injured his ankle during a Sunday football match and is brought into the emergency department by his father. His father steps out to take a call on his mobile phone. You continue to assess the boy, who you believe is Gillick competent. When you ask if he is taking any other medication, he confides he is taking human growth hormone to help build up his muscle. He asks you not to tell his father. What do you do?

A - Ignore the patient’s wishes as he is not yet 18 and clearly irresponsible. You have a quiet word with his father who is in the waiting area.

B - Explain to the patient the risks he is running and encourage him to talk to his parents. You also give him the number of a drugs support group for further advice.

You and the other doctors from your year at medical school have set up a Facebook group. You use it to:

A - Tell them about the amusing patients you see while on your placements. After all this is a closed group so no one else can read what you write.

B - Arrange nights out with your friends and keep in touch.

A journalist calls you at the GP surgery where you are on a rotation. A patient has alleged that you failed to diagnose her broken wrist, leaving her in pain for three days. The journalist wants your side of the story. Do you:

A - Tell him that a scaphoid fracture is always difficult to diagnose, particularly when the patient fidgets and won't allow you to examine them properly.

B - Explain you cannot comment because of your duty of patient confidentiality and call the MDU straight away.

During a ward round you see a patient with painful keloid scarring following breast reconstruction surgery. You have a particular interest in dermatology and with her consent you take a picture on your smartphone. A colleague who is also interested in the specialty later asks you to forward the image. What do you do?

A - Send the image to your colleague with a few relevant details about the patient’s age and treatment.

B - Explain that you cannot do this without the patient’s informed consent.

As you are passing through reception you overhear a receptionist joking with a colleague about an obese patient who has broken a chair in the consulting room within earshot of other patients. Do you:

A - Join in with a joke of your own about fat patients. After all, a sense of humour is important in medicine.

B - Tell your supervisor what you have seen. He later arranges for all reception staff to attend refresher training on patient confidentiality.

You are an ST1 in obstetrics and gynaecology. One evening you are in the supermarket when you see a patient who was discharged a couple of weeks ago following a caesarean section. Do you:

A - Introduce yourself to the patient, congratulate her and wish her a speedy recovery. You later remember she was desperately disappointed that the baby was a boy.

B - Leave her alone. You don't want to risk embarrassing her and breaching her confidentiality by discussing her treatment in public.

You have treated a patient who sustained minor facial injuries. Shortly after he is discharged, you are approached by a policewoman wanting to know his name and address as he is suspected of leaving the scene of a robbery. What do you do?

A - Pass on the patient’s details straight away. You thought there was something untrustworthy about him.

B - You don't believe you would be justified in disclosing this information in the public interest in these circumstances and explain that you need the patient’s consent to pass on his details.

There never seems to be enough time to complete an audit for your portfolio and you consider working on the project while you are away for a weekend. Do you:

A - Save all the data on a memory stick so you can work on the project from the comfort of your own laptop.

B - First seek advice from your trust’s data controller about your trust’s procedures for encrypting and transferring information.

How did you do?

Mostly As

You may be too easily tempted to reveal confidential information about a patient and the care they are receiving when this cannot be justified. Even if you are acting with the best of intentions, disclosing such details without the patient's consent can easily result in a complaint and get you into difficulties with your employer, deanery and with the GMC. We recommend you check out the MDU's medical ethics and law online learning module at themdu.com/learn which should enhance your understanding of confidentiality and how this important principle relates to your daily practice.

Mostly Bs

Congratulations. You clearly understand your central role in safeguarding patient confidentiality and are unlikely to undermine the trust placed in you by your patients.

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This page was correct at publication on . Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

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